The Home Care Alliance has several important amendments filed in the FY 2012 Senate budget and messages to support these initiatives are available here.
Here are the issues HCA is advocating for:
Amendment #483 – Home Health Care Rates, filed by Senator Michael Moore.
- The MassHealth home health payment rate was cut by 20 percent to patients receiving skilled nursing care past 60 days of care in December of 2008. This created a new payment category that goes from $86.99 to $69.59 for patients that require longer periods of care and who are at a greater risk of inpatient facility admissions or readmissions.
- Since all of MassHealth’s home health services receive a 50 percent federal match, the actual state expenditures reflect only half of a $7.1 million budget increase.
Amendment #478 – MassHealth Home Care, filed by Senator Steven Tolman.
- This amendment establishes a special MassHealth rate to reward home health agencies that are successful in helping patients discharged from acute care avoid a costly re-hospitalization for the same condition for which they were originally hospitalized.
- The hospitalization would have to be avoided for at least 30 days in order for the payment to be administered. The Secretary of Health and Human Services shall determine the rate, which will be based on a nurse-led team model.
- This provision would increase the efficiency of care and save costs for the state in avoiding rehospitalizations.
Amendment #481 – Pediatric Home Care Services, filed by Senator Michael Moore.
- This amendment does not increase any rate, but merely shifts existing payment recognizing a home health agency’s administrative requirements. Also, this amendment ensures safety and quality by allowing only registered nurses to care for multiple patients in a single setting.
Amendment #593 – Telehealth Reimbursement, filed by Senator Richard Moore.
- In recent years, several states have all moved forward with incorporating coverage of telehealth into their state plan, waiver home care programs, or have authorized funding for demonstration projects to support telemonitoring equipment purchases.
- The Centers for Medicare and Medicaid Services also recognize and define telehealth billing and reimbursement practices.
- Telehealth and remote care management programs are not only proven to reduce admissions to hospitals and nursing homes, but also reduce the frequency of home health visits.
- Such lower cost services increase communication with physicians and caregivers, which contributes to the enhancement of care. It also increases patient self-management and is widely regarding as a cost savings measure supported by a number of studies and pilot programs.
Amendment # 589 – Adult Day Health Services, filed by Senator Richard Moore.
- A $55 million cut to Adult Day Health (ADH) services was proposed in the Governor’s budget and this amendment would freeze the current level of reimbursement to prevent that reduction from occurring. The amendment would also impose a moratorium on new ADH facilities until a study on ADH rates and services is completed by the Executive Offices of Health and Human Services and Elder Affairs.
Amendment #586 – MassHealth/Medicare Dual Eligible Demonstration Project, filed by Senator Thomas Kennedy.
- The Patrick administration is exploring a demonstration program that would offer a new integrated care product to MassHealth members that are dually-eligible for Medicare. The new program would apply to individuals who are eligible for both Medicare and Medicaid, and who are between 21 and 65 years old.
- The proposal envisions the MassHealth program receiving Medicare funds from the federal government for the purpose of managing the care of dual eligible patients. MassHealth would then pay “Integrated Care Entities” a global payment for the care of a group of enrollees.
- The governor’s FY2012 state budget recommendation assumes $50 million in savings from the proposed initiative. MassHealth states these savings will be achieved by better coordination and management of the dually eligible population. While the $50 million savings estimate is not based on provider rate reductions, legislative guidelines for this dually-eligible demonstration effort are needed to assure hospital, physician, and home health care payments continue at current Medicare levels.
Return to www.thinkhomecare.org.